Organization
FAIRFAX NEONATAL ASSOCIATES, PC
Active
Parent organization
FAIRFAX NEONATAL ASSOCIATES
Other names
Pediatric Surgical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAIRFAX NEONATAL ASSOCIATES
Authorized official
CAROLYN HALTERMAN (PROJECT MANAGER)
(703) 289-1448
Entity
Organization
Contact information
Practice address
2730 PROSPERITY AVE, STE C, FAIRFAX, VA 22031-4329
(703) 560-2236
Mailing address
2730 PROSPERITY AVE # B, FAIRFAX, VA 22031-4329
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
—
—
Other
Enumeration date
06/05/2007
Last updated
05/18/2016
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